Individual provider Active NPI

Brien Hsu, DDS

  • General Practice Dentistry
  • Rancho Cucamonga, CA
National Provider Identifier
1356428643
Registry record updated Nov 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47485 Issued in CA
Practice address
11458 Kenyon Way Ste 120
Rancho Cucamonga, CA 91701-9219
Phone
(909) 941-2811
Fax
(909) 941-7271
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47485 CA Primary

Addresses

Primary practice location

11458 Kenyon Way Ste 120
Rancho Cucamonga, CA 91701-9219

Mailing address

11458 Kenyon Way Ste 120
Rancho Cucamonga, CA 91701-9219
Phone (909) 941-2811

Other identifiers 1

IdentifierTypeStateIssuer
G92638-01OtherCAMEDICAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160608000875 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9335466648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47485CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Brien Hsu DDS Inc CurrentSince Mar 4, 2015 Accepting new patients
Serena Hsu DDS Ms a Professional Corporation PastSince Nov 12, 2023 Accepting new patients

Locations

11458 Kenyon Way
Ste 120
Rancho Cucamonga, CA 91701
Phone (909) 941-2811

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416614400000",
    "number": "1356428643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11458 KENYON WAY STE 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019219",
            "telephone_number": "909-941-2811",
            "fax_number": "909-941-7271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11458 KENYON WAY STE 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917019219",
            "telephone_number": "909-941-2811",
            "fax_number": "909-941-7271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU",
        "first_name": "BRIEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "G92638-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.